Eye care is a USD 26 billion segment of healthcare, growing at high-single-digit rates; Alcon had forecast high-single-digit sales growth in 2011 as a stand-alone company. Growth in the sector is driven by aging of populations, high levels of unmet medical need and continued economic development of emerging countries where millions of people could benefit from existing products.

Cataracts – clouding of eye’s natural lens as a result of aging or injury – are the most common cause of reversible loss of vision worldwide. According to estimates by the World Health Organization, more than 40 million people lack useful vision and are unable to find their way unaided; cataracts are responsible for almost half of these cases. By the age of 80, more than half of all Americans have either had a cataract, or cataract surgery.

The only known treatment for cataracts is surgical removal of the natural lens which, if combined with implantation of a replacement intraocular lens, can restore vision. The broad adoption of ultrasound technology for lens extraction, as well as development of foldable intraocular lenses, has led to smaller surgical incisions, faster recovery times and improved patient outcomes. According to the US National Institutes of Health, about 90% of people have improved vision after cataract surgery.

Alcon’s AcrySof family of lenses is the most frequently implanted intraocular lens in the world. In addition, advanced technology intraocular lenses now make it possible for surgeons to combine cataract surgery with “refractive” procedures to correct vision problems such as astigmatism and presbyopia, the inability to read comfortably at close distances which usually appears after the age of 40.

“If people live long enough, they will get a cataract. Today we have the ability to deal with cataracts and to address this form of preventable blindness,” Mr. Buehler says.

Still, an estimated 18 million people around the world have gone blind as a result of untreated cataracts. In some emerging countries, a shortage of trained surgeons restricts the number of cataract replacement procedures and results in blindness due to conditions that could be readily addressed.

To enhance access to treatment, Alcon provides training of eye care professionals at more than 200 training centers in 60 countries. In emerging countries such as Brazil, Alcon has forged partnerships with societies of cataract surgeons and local hospitals to increase the number of trained surgeons, ophthalmic technicians and technical service personnel.

“Additional horsepower”

Glaucoma, a collection of disorders that results in optic nerve damage due to elevated intraocular pressure, is the second leading cause of blindness today but existing medicines treat only the symptoms of elevated intraocular pressure. “We’re still not dealing with the underlying disease in glaucoma,” Mr. Buehler observes.

Underpinning a staunch commitment to innovation, Alcon plans to invest approximately USD 4 billion in research and development over the next five years. With nearly 2 000 people around the world dedicated to research and development, Alcon is the largest investor in eye-related research outside of publicly funded scientific institutions. To date, however, the company has focused primarily on preclinical and clinical development; most early-stage compounds were licensed from other companies and academia.

The new Alcon Division will step up early-stage discovery programs. “Going forward, the broad-based research program at Novartis will provide us additional horsepower to bring in more molecules,” Mr. Buehler says. Alcon has a catalogue of biological targets that have been validated for treatment of certain ophthalmic diseases and discussions with the Novartis Institutes for BioMedical Research (NIBR) will explore compounds discovered by NIBR with potential to regulate those targets. “We would want to take molecules and put them into our testing models for ophthalmic indications as quickly as possible,” Mr. Buehler says.